尿膜管
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出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2015/05/14 06:31:51」(JST)
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Urachus |
Vertical section of bladder, penis, and urethra. Urachus is seen at top
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Urachus is #1
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Identifiers |
Gray's |
p.1213 |
MeSH |
A16.254.835 |
Dorlands
/Elsevier |
u_03/12837658 |
Anatomical terminology |
The urachus is a fibrous remnant of the allantois, a canal that drains the urinary bladder of the fetus that joins and runs within the umbilical cord.[1] The fibrous remnant lies in the space of Retzius, between the transversalis fascia anteriorly and the peritoneum posteriorly.
Contents
- 1 Formation
- 2 Pathology
- 3 Additional images
- 4 References
- 5 External links
Formation
The vesico-urethral portion of the urogenital sinus absorbs the ends of the Wolffian ducts and the associated ends of the renal diverticula, and these give rise to the trigone of the bladder and part of the prostatic urethra. The remainder of the vesico-urethral portion forms the body of the bladder and part of the prostatic urethra; its apex is prolonged to the umbilicus as a narrow canal, which later is obliterated as the urachus goes on to definitively form the median umbilical ligament (urachus).
Pathology
Failure for the lumen of the urachus to be filled in leaves a patent (open) urachus. The telltale sign is leakage of urine through the umbilicus. A patent urachus needs to be surgically removed. There are four anatomical causes:
- Urachal cyst: there is no connection between the bladder and the umbilicus
- Urachal fistula: there is free communication between the bladder and umbilicus
- Urachal diverticulum [Vesicourachal diverticulum]: the bladder exhibits outpouching[2]
- Urachal sinus: the pouch opens toward the umbilicus[3]
The urachus is also subject to neoplasia. Urachal adenocarcinoma is histologically similar to adenocarcinoma of the bowel.
Additional images
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CT scan (sagittal reconstruction) showing an urachus rest as an incidental finding in a 44 year old man, the trajectory moves forward and upward from the bladder to the umbilicus in the midline.
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Ultrasound of fetus showing urachus duct from bladder to the umbilicus.
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Ultrasound of fetus showing urachus duct from bladder to the umbilicus.
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Ultrasound of fetus showing urachus duct from bladder to the umbilicus.
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Ultrasound of fetus showing urachus duct from bladder to the umbilicus.
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Ultrasound of fetus showing urachus duct from bladder to the umbilicus.
References
This article incorporates text in the public domain from the 20th edition of Gray's Anatomy (1918)
- ^ Larsen, "Human Embryology," 3rd ed., pg. 258
- ^ Le, Tao; Bhushan, Vikas; Vasan, Neil (2010). First Aid for the USMLE Step 1: 2010 (20th Anniversary ed.). USA: The McGraw-Hill Companies, Inc. p. 122. ISBN 978-0-07-163340-6.
- ^ Guray, Sogut, et al. (2000) Urachal Cyst. Eastern Journal of Medicine 5(2):76-78.
External links
- ‹The template EMedicineDictionary is being considered for deletion.› Urachus at eMedicine Dictionary
- Swiss embryology (from UL, UB, and UF) turinary/patholurinary07
- Persistent urachus at moorabbinvet.com.au
- Repair at pennhealth.com
- Vesico-urachal Diverticulum Radiology (CT Images)
Development of the urinary and reproductive systems
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Common |
- Mesoderm
- Intermediate mesoderm
- Lateral plate mesoderm ("LPM")
- Endoderm → Cloaca → Urogenital sinus ("US")
- Endoderm+Ectoderm → Cloacal membrane
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Urinary system |
- Nephrogenic cord → Kidney
- Mesonephros (Mesonephric tubules)
- Mesonephric duct → Ureteric bud + Metanephrogenic blastema
- US → Urinary bladder + Urethra + Primary urethral groove + Urachus
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Reproductive system |
Internal |
- Gonadal ridge → Indifferent gonad → Gonadal cord (Cortical cords, Testis cords)
- Pronephric duct → Mesonephric (Wolffian) duct + Paramesonephric (Müllerian) duct (Vaginal plate)
- Urogenital sinus → Prostate or Skene's gland
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External |
- LPMGenital tubercle → Labioscrotal swelling → Scrotum or Labia majora
- LPM → Genital tubercle → Primordial phallus → Penis or Clitoris
- Peritoneum → Processus vaginalis or Canal of Nuck
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See also |
- List of homologues of the human reproductive system
- Prenatal development
- Embryogenesis
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Index of the urinary system
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Description |
- Anatomy
- Physiology
- Development
- Cells
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Disease |
- Electrolyte and acid-base
- Congenital
- Neoplasms and cancer
- Other
- Symptoms and signs
- Urine tests
- Blood tests
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Treatment |
- Procedures
- Drugs
- Intravenous fluids
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Index of reproductive medicine
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Description |
- Anatomy
- Physiology
- Development
- sex determination and differentiation
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Disease |
- Infections
- Congenital
- Neoplasms and cancer
- male
- female
- gonadal
- germ cell
- Other
- Symptoms and signs
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Treatment |
- Procedures
- Drugs
- benign prostatic hypertrophy
- erectile dysfunction and premature ejaculation
- sexual dysfunction
- infection
- hormones
- androgens
- estrogens
- progestogens
- GnRH
- prolactin
- Assisted reproduction
- Birth control
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UpToDate Contents
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English Journal
- Pseudomyxoma peritonei originating from urachus-case report and review of the literature.
- Agrawal AK1, Bobiński P2, Grzebieniak Z1, Rudnicki J3, Marek G1, Kobielak P1, Kazanowski M1, Agrawal S3, Hałoń A4.Author information 1Second Department of General and Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland.2Department of General Surgery ii , Lower-Silesian Specialised Hospital, Wroclaw, Poland.3Wroclaw Medical University, Wroclaw, Poland.4Division of Pathomorphology and Oncological Cytology, Wroclaw Medical University, Wroclaw, Poland.AbstractPseudomyxoma peritonei (pmp) is a rare clinical condition defined as extensive intraperitoneal spread of mucus associated with a variety of mucinous tumours of varying biologic behavior. Although appendix or ovaries have usually been implicated as the primary site, cases have been reported in association with neoplastic lesions of other sites. Pseudomyxoma peritonei originating from urachal remnants is a unique entity, reported only 18 times in the English literature thus far. Considering the rarity of the lesion, we report the case of a 50-year-old man surgically treated for pmp associated with a low-grade mucinous urachal neoplasm. Unique aspects of case are the low histologic aggressiveness of the causative lesion (reported only twice worldwide) and the early stage of the disease, with a relatively small amount of intraperitoneal free mucin. Review of the literature about pmp in general and a collation of previously reported cases of pmp originating from the urachus are presented and discussed.
- Current oncology (Toronto, Ont.).Curr Oncol.2014 Feb;21(1):e155-65. doi: 10.3747/co.21.1695.
- Pseudomyxoma peritonei (pmp) is a rare clinical condition defined as extensive intraperitoneal spread of mucus associated with a variety of mucinous tumours of varying biologic behavior. Although appendix or ovaries have usually been implicated as the primary site, cases have been reported in associ
- PMID 24523614
- Mucinous neoplasm arising in a urachal cyst: a first in the pediatric population.
- Gupta S1, Bhaijee F1, Harmon EP2.Author information 1Division of Pediatric Urology, Department of Surgery, University of Mississippi, Jackson, MS.2Division of Pediatric Urology, Department of Surgery, University of Mississippi, Jackson, MS. Electronic address: Eharmon@umc.edu.AbstractUrachal anomalies are relatively uncommon and result because of incomplete obliteration of the urachus prenatally. In children, urachal cysts and sinuses constitute the common presentations, and these can sometimes become secondarily infected. Malignant involvement of the urachus in the pediatric population is rare, and primary urachal adenocarcinoma is reported exclusively in adults. Herein, we present the case of an adolescent girl with a low-grade mucinous neoplasm arising in a urachal cyst and discuss its significance.
- Urology.Urology.2014 Feb;83(2):455-6. doi: 10.1016/j.urology.2013.09.034. Epub 2013 Nov 12.
- Urachal anomalies are relatively uncommon and result because of incomplete obliteration of the urachus prenatally. In children, urachal cysts and sinuses constitute the common presentations, and these can sometimes become secondarily infected. Malignant involvement of the urachus in the pediatric po
- PMID 24231219
- Paediatric urachal benign teratoma: a case report and review of the literature.
- Kingo PS1, Høyer S, Marinovskij E, Rawashdeh YF.Author information 1Department of Urology, Aarhus University Hospital, Skejby, Denmark.AbstractUrachal anomalies are most often seen in children, seldom in adults, but are in general considered rare. The estimated incidence is one in 5000-7000 live births and appears twice as common in males. Despite their rarity, they need to be considered by clinicians, as diseases in the urachus can mimic many abdominal and pelvic conditions and constitute an important differential diagnosis to these. Diagnosis can be made by clinical examination and imaging modalities (computed tomography, ultrasonography, magnetic resonance imaging, voiding cystourethrogram), but some are discovered incidentally. Management of symptomatic urachal anomalies is surgery. Histological examination of the specimen should always be performed to rule out malignancy. We report on the first adolescent described in the literature diagnosed with a urachal sinus harboring a benign teratoma. A combination of the two pathologies is by inference an extremely rare condition, which we here report on and we review the relevant literature on this topic.
- APMIS : acta pathologica, microbiologica, et immunologica Scandinavica.APMIS.2014 Jan 30. doi: 10.1111/apm.12216. [Epub ahead of print]
- Urachal anomalies are most often seen in children, seldom in adults, but are in general considered rare. The estimated incidence is one in 5000-7000 live births and appears twice as common in males. Despite their rarity, they need to be considered by clinicians, as diseases in the urachus can mimic
- PMID 24475742
Japanese Journal
- 納所 洋,植村 貞繁,牟田 裕紀,久山 寿子,山本 真弓,吉田 篤史,渡部 茂
- 日本小児外科学会雑誌 48(6), 961-964, 2012-10-20
- 尿膜管開存症は臍帯嚢胞や臍帯浮腫との関連がみられる稀な先天異常である.胎児MRIで臍帯嚢胞及び臍帯浮腫を認めた尿膜管開存症の1例を経験したので報告する.症例は胎生23週の出生前超音波検査で臍帯嚢胞を指摘された.嚢胞は徐々に増大し,臍帯浮腫が顕著となった.胎生35週の時点で胎児MRIを行ったが,臍帯に3つの嚢胞と著明な浮腫を認めた.38週2日に帝王切開で出生した.臍帯嚢胞及び浮腫に加え,臍帯基部から …
- NAID 110009544286
- 症例報告 胎児MRIで臍帯胞を認めた尿膜管開存症の1例
- 松村 英理,大城 吉則,宮城 亮太,木村 隆,安次嶺 聡,町田 典子,呉屋 真人,宮里 実,斎藤 誠一,林 昭伸
- 西日本泌尿器科 74(8), 454-459, 2012-08-20
- NAID 10031067805
Related Links
- urachus [u´rah-kus] a fetal canal connecting the bladder with the allantois, persisting throughout life as a cord (median umbilical ligament). adj., adj u´rachal. patent urachus a condition in which the urachus remains a hollow tube ...
- urachus [u´rah-kus] a fetal canal connecting the bladder with the allantois, persisting throughout life as a cord (median umbilical ligament). adj., adj u´rachal. patent urachus a condition in which the urachus remains a hollow tube ...
Related Pictures
★リンクテーブル★
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- 英
- urachus (L), allantoic duct (KL), pedicle of allantois
- 関
- 正中臍索
- 最初は、膀胱は尿膜と連続しているが、尿膜の腔が閉鎖すると、太い線維性索となった尿膜管が膀胱頂と臍を連結する(L.300)
*発生の後期には内腔が閉鎖して、成体では正中臍索という索状の結合組織となる。
臨床関連